Complex Claim Referrals

Amplify collections from complex claims

Take control of costly and challenging complex claims management, including Motor Vehicle Accident (MVA)/Third-Party Liability (TPL), Workers’ Compensation (WC) and Veterans Affairs (VA). Our knowledge of the myriad rules, regulations and requirements for complex claim processing ensures the patient receives the qualified level of coverage while securing maximum reimbursement.


Your complex claim processing, simplified

Speed up revenue recovery from specialized and complex claims, achieve a lower cost-to-collect, and boost ROI. Our teams of attorneys, clinicians and revenue cycle experts manage your complex claims from admission through resolution to ensure appropriate reimbursement. Complex Claim Referrals lets you realize an average 10%-15% lift in cash over other solutions.

Resolve more claims faster

Leverage our highly skilled professionals for expedient and accurate recovery of your most complex cases while your team focuses on easier-to-collect claims.

Optimize reimbursement across payers

Secure the maximum reimbursement regardless of payer with our unique knowledge of state and federal rules, regulations and requirements.

Get full lifecycle support

Rest assured, every claim receives thorough monitoring and follow-up from admission through resolution, capturing any missed opportunities.

Boost efficiency and keep improving

Partner with R1 as a specialized extension of your team and share our knowledge to help you work complex claims more effectively. Here’s how we help you manage different types of complex claims.

Our expertise spans all stages of the workers’ compensation claim process. We ensure accurate insurance capture and leverage our unique expertise and intelligent technology to provide precise pricing and identify opportunities. Our data-driven insights, root cause analysis and enterprise reporting drive ongoing operational improvements.

Our Motor Vehicle Accident solution manages a very difficult and time-consuming claims process to free in-house staff for more high-volume, high-yield work. Our legal experts act as liaisons with attorneys, file liens as appropriate and negotiate settlements on behalf of the provider.

Our VA solution addresses a difficult-to-process segment of accounts receivable. We combine a specialized process with legal expertise and claim resolution experience to optimize reimbursement and enable clients to devote staff to higher-yield AR segments.

Looking to learn more about us? It all starts here.